Changing Medications

Caelin had an excellent night last night... and this morning his gas revealed that his blood count was where it should be so the good night was all Caelin, not because he was too exhausted from having no blood! lol

Today was Friday the 13th but it was a good day! Caelin continued with working on oral feeding. He took 2 mL of breast milk by mouth practicing "taste." This is where we squeeze in droplets of milk as he is sucking on his binky. Since he did so well yesterday and today, the speech pathologist decided to let him try sucking milk directly from a bottle nipple for the first time. He sucked out the milk, then gagged and spit up. She said this is normal and does not attribute it to acid reflux but more so to the fact that the milk came straight out into his mouth rather than gliding in slowly between his cheek and binky. Hopefully Cael will be able to try again tomorrow!

He was happy pretty much all day! A couple times when he woke up he would be fussy, but would calm quickly with a diaper change, binky, or just being talked to. He spent a lot of his time awake and alert! He loves to look around and interact with Mommy and Daddy.

The biggest news from today is they are starting to transition him to the medications he will be on when he comes home. So he only gets his lasix once daily instead of twice and it is now oral instead of through an IV. They have reduced his Milrinone from 0.375 to 0.25 and he will most likely come off it tomorrow. He is now off Heparin and on Lovenox. The Heparin was a continuous weight-based drip which required them to check his levels every six hours by drawing approximately 7-10 cc's of blood. So thank goodness, they no longer have to do this! They will have to check to make sure the Lovenox is therapeutic. Lovenox is an anticoagulant injection used in combination with aspirin to help prevent blood clots. He tolerated the transition from Fentanyl to Methadone at 0.3 so they reduced it to 0.2 today. His chest therapy was discontinued because his lungs look healed; they no longer show any signs of being collapsed or having any fluid in them. Also, his blood labs now need to be done only Mondays and Thursdays instead of Mondays, Wednesdays, and Fridays. The only thing he is still on is the Vapo Therm. They did not want to take him off of it yet because they made so many adjustments to his medications and they are going up on feeds. They are talking about transitioning him off of it tomorrow or Sunday.

He is now on 8 mL/hr of breast milk. The orders are for him to go up by 2 ml/hr every 12 hours. So at midnight he will be bumped up to 10 mL/hr. He had only one instance of emesis (vomiting) today, and it may have been because of the medication the nurse dispensed into the tube, not the feeds. Hopefully he continues to do well and handle the feeds as they increase because if not, the doctors are not sure what to do. But if he does handle them, then we get closer to him being discharged and coming home! :) He gets three different medications for acid reflux and digestion- Reglan, Zantac, and Prevacid. All of these medications he receives orally. The Zantac and Prevacid Mommy mixes with breast milk so Cael can swallow them without gagging (he does not like the taste). But the Reglan he does not seem to mind too much. So he has done an excellent job with swallowing these medications- hopefully they will help prevent vomiting as his feeds increase.